Eighty per cent of patients transplanted under the auspices of this grant application come from out of state. This separation from family and community support increases the psychological, emotional, social and financial stress already associated with severe illness. All patients treated with marrow transplantation hae potentially fatal diseases and there is a significant risk of death in the first 100 days after transplantation. In this setting trained social workers are necessary to provide the psychosocial support and/or crisis intervention. Family support and involvement is more intense in marrow transplantation than in almost any other medical treatment due to donation of both marrow and platelets by family members. This leads to complex intrafamily problems related to the impact of the transplant procedure on the family unit. Because the donors are also involved in the initial consultations and long term evaluations, we plan to evaluate the effects of marrow transplantation on psychosocial functioning of the patient, family and donor.